Social distancing, school closures, and stay-at-home orders became hotly disputed during the 2020 COVID-19 crisis. How should these protocols be viewed today?
The new book “In Covid’s Wake: How Our Politics Failed Us” by a pair of Princeton University professors finds no evidence these “non-pharmaceutical interventions” actually reduced mortality rates. What the co-authors do find is that the measures did significant damage to U.S. society — with many mainstream scientists, journalists, and scholars reluctant to make a frank appraisal.
“We argue that, in the pandemic, disagreement was moralized prematurely, and dissent was treated intolerantly,” said co-author Stephen Macedo, the Laurance S. Rockefeller Professor of Politics at the University Center for Human Values. “We see these as failures of educated elites to live up to some of our own deepest values of being open to criticism and divergent points of view.”
In a talk last week hosted by the Department of Government, Machado and co-author Frances Lee, a professor of politics and public affairs, outlined the book’s thesis and took tough audience questions.
Macedo kicked things off with a survey of pandemic planning documents that predate COVID-19. Reading John M. Barry’s “The Great Influenza” (2004) had piqued the interest of former President George W. Bush. His administration advanced a strategy of containment, influenced by mathematical modelers who said children would likely be primary carriers.
A National Strategy for Pandemic Influenza Implementation Plan, released by the Centers for Disease Control in 2006, emphasized the promise of school closures. “They predicted that school closures, by themselves, could secure a 50 percent reduction in peak death rates,” Macedo said.
Over the next 13 years, several experts cautioned against what the American Civil Liberties Union characterized as “aggressive, coercive actions” in its own 2008 pandemic preparedness report. Frequently emphasized was the danger of disproportionately harming vulnerable populations, including kids from low-income families.
“But the policy flipped on a dime in March 2020,” Macedo said, citing a February 2020 World Health Organization-China report from Wuhan. “The joint mission report unequivocally urged every country in the world to embrace what was, in effect, a zero-COVID policy by the severe implementation of lockdown policies.”
There was some pushback from infectious disease experts in the early days of the pandemic. But, the authors say, the marketplace of ideas was experiencing its own lockdown by the October 2020 release of the Great Barrington Declaration, with its urgent call to relax restrictions for those at minimal risk. The statement, written by three epidemiologists with distinguished credentials, drew thousands of signatories. But it was quickly branded by critics in public health and government as “dangerous” and “fringe.”
“Part of it was that people settled on a wartime framing,” Macedo offered, citing the titles of two early pandemic memoirs — Deborah Birx’s “Silent Invasion” and Sanjay Gupta’s “World War C.”
Co-author Lee picked up the thread by examining pandemic outcomes across 50 states. At first, blue and red states implemented similar measures, she recalled. But the policymaking appeared deeply polarized by Labor Day.
“Across the South, the Plains, and the Mountain West, schools reopened in the fall of 2020,” Lee said. “But nearly half of public schools around the country were still closed in March 2021.”
By January 2023, states led by Republicans had suffered mortality rates nearly 30 percent higher than their Democratic-led counterparts, according to the co-authors’ assessment of CDC data. But they found no evidence that blue states benefited from longer school closures and stay-at-home orders.
“If you examine COVID mortality across the period before vaccines became available,” Lee said, “there’s not a statistically significant difference.” This was true even when controlling for the percentage of elderly, uninsured, or obese residents. A separate analysis, published in the Lancet in 2023, surfaced similar conclusions.
Yet these non-pharmaceutical measures came at a steep cost, with Lee quickly rattling off more than a dozen examples — from a spike in alcohol-related deaths to emptied downtown business districts and learning losses for schoolchildren.
The injury was also fiscal. Congress authorized more than $5 trillion in COVID relief spending, aimed mostly at helping Americans stay financially afloat during the shutdowns.
“In the first quarter of 2020, total debt held by the public leapt from 80 percent of gross GDP to more than 100 percent,” Lee explained. “This higher plateau persists post-pandemic — and that higher level of indebtedness also entails a higher cost for debt service that puts constraints on our ability to respond to the next economic crisis or address other priorities.”
Are educated elites, largely aligned with the Democratic Party, finally ready for an honest reckoning with the COVID era’s groupthink? Macedo has his doubts. He pointed to an August 2023 JAMA Network Open article outlining varieties of misinformation shared by physicians on social media, with the aim of helping governments and professional societies censor bad actors.
Included were the Wuhan lab leak theory, concerns about the harms of masking children, and suggestions that natural infection can contribute to herd immunity. “All of these matters, as of August 2023, were either true or at least arguable,” Macedo said.
In a lightning-round review of the book’s lessons, Macedo emphasized the need for open debate and viewpoint diversity in navigating future crises.
“We also need greater honesty on the part of public officials — especially in public health,” he concluded, noting the resulting hit to the field’s credibility. “There’s too much of a tendency to not tell the whole truth, because they see their role partly as messaging and trying to nudge people’s behavior. But I think we are owed honesty about the limits of their knowledge.”
During the Q&A session, one attendee pushed back on the authors’ call for prioritizing honesty in a public health emergency. Given the pandemic’s devastating loss of life, the comparison to wartime governments protecting national security was made.
In response, Macedo referred to previous scholarship on the Vietnam War, including Barbara W. Tuchman’s “The March of Folly” (1984). “We think this is another case where people are engaging in wishful thinking — trying to get the public to go along and not being transparent about the cost of these measures and the likelihood of success,” he said.
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